A Disclosure Provision in Health Overhaul Sparks a Fight

A fight on the sidelines of the health legislation shows just how thorny overhauling the health care business can be.

Companies that manage drug benefits for insurers are scrambling to scrap a provision that would require them to disclose more financial information, including the difference between the amount they charge insurers and the amount they reimburse pharmacies.

The amendment was added to the Senate Finance Committee’s bill and a similar provision is in the bill that passed the House Energy and Commerce Committee.

Mark Merritt, president and chief executive of the Pharmaceutical Care Management Association, said that would screw up negotiations between benefit managers and pharmaceutical companies over drug prices. “There’s no upside to this, but there’s a lot of downside,” Merritt told Washington Wire. “We are forced to play poker with drug companies with our cards facing up.” He predicted drug prices would rise.

Merritt said he is “casting a wide net” as his group lobbies senators and congressmen to drop the provision from a final bill. That might be a tough sell.

Supporters say the disclosure would cut drug prices because the benefit managers now profit from hidden revenues, including rebates from drug companies. “This kind of transparency will help drive down drug prices in a significant fashion,” Sen. Maria Cantwell (D., Wash.), who sponsored the amendment, recently said in a statement.

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